How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,995 to $15,136Professionalmedian $2,239 · 10th to 90th $1,549 to $2,692
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,584.89 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $17,782.79 | Facility | None | $3,630.78 | $9,332.54 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,344.23 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $6,456.54 | Facility | None | $4,265.80 | $4,786.30 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,698.24 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,511.89 Typical High $4,466.84 | Facility | None | $1,023.29 | $2,511.89 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,511.89 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,737.80 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,454.71 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $10,471.29 | Facility | None | $1,023.29 | $1,047.13 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $4,365.16 | Professional | None | $1,023.29 | $1,230.27 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,819.70 | $2,570.40 |
23 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $316.23 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,174.90 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $234.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,370.32 Median $14,125.38 Typical High $26,915.35 | Facility | 50 · Both sides | $5,370.32 | $14,125.38 | $26,915.35 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,311.31 Typical High $3,630.78 | Professional | 50 · Both sides | $2,951.21 | $3,311.31 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,230.27 | $1,380.38 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $2,691.53 Typical High $2,884.03 | Professional | 63 · Small infant | $2,398.83 | $2,691.53 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 80 · Assistant surgeon | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $354.81 | $389.05 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | AS · PA/NP assist | $269.15 | $302.00 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $794.33 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $316.23 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,174.90 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $234.42 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $158.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,778.28 | $1,778.28 |
Where Idaho sits
The same service costs 16.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 10th of 51
$2,239
AK $5,012TX $309
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.